Prevent! Period.

Well, we can only do so much, yes we 'only' can do só much to prevent ourselves from running into health problems. Of course not every health problem. There is an increase of awareness, the use of technology, education and trust. Now, trust is an expensive good nowadays. Like all the other aspects builds slow and travels fast, when breached. As I'm writing this newsletter, in an extra window on my computer developing stores are scroll by.

Prevention in health(care) comes in several identities. To prevent conditions to occur (healthy food and habits), in technology to prevent as much damage as possible (early warning) and making sure the right and credible information is being communicated so people make informed decisions.

This newsletter wanted to touch on different lenses of 'prevention', hopefully some would not account for the obvious ones and I would love to hear your ideas and perspectives in the comments of this newsletter, on Linkedin.

Wishing you all a Happy and Safe 2021

WHO urges governments to promote healthy food in public facilities

Let's start with the well known, but still badly needed approach : health food. Public settings, such as schools, childcare centres, nursing homes, hospitals and correctional facilities and all other canteens of public institutions, can play a key role in ensuring people are provided with healthy food and helping prevent the 8 million annual deaths currently caused by unhealthy diets. A new WHO Action framework for developing and implementing public food procurement and service policies for a healthy diet aims to increase the availability of healthy food through setting nutrition criteria for food served and sold in public settings. The action framework also aims to reduce preventable diseases and deaths from high consumption of sodium and salt, sugars and fats, particularly trans fats, and inadequate consumption of whole grains, legumes, vegetables and fruit. Click to read more.

Early warning can save lives.

Early warning, but even better early alarming and dispatch when a cardiac arrest can be a way to prevent a serious event from happening or limiting the damage done as much as possible. Over the past years in many places -like in the Netherlands- communities invested in AED's (Automatic External Defibrillator).

Back in 2010 -during my tenure at Radboudumc- I took the challenge to create an inventory of all the Dutch AED's and map them so you could use an app or Google maps, whenever you wanted to know where the nearest AED would be. Something now in 2021 looks like totally the obvious, but back in the days, it was headline news. (Introduced in my first TED-talk -seems like a century ago- starting as of minute 2:39 )

Also, other organisations stepped up with a network of volunteers to be alarmed in case of a cardiac arrest or other heart-problems like AF(Atrium Fibrillation), which have achieved great results.

Fast forward to 2021 : The Dutch Heart Association thinks this is not enough. Because these are the examples when someone (family, coworker or bystander) is around. Many deaths occur when nobody else is around, an unwitnessed cardiac arrest..

So they've given themselves the next level challenge to explore the possibilities of an autonomously early warning system that also can dispatch people to the location, so even if nobody else but the 'patient' is around. "Unwitnessed cardiac arrest", they named the project. For this, they've issued a grant to help create this over the next 5 years or so. This could be interesting for 'big tech' companies combined with (local) communities. So not 'just' a device or smart technology alone that can monitor or signal an abnormality, but a device that does so, ánd location-based alarm ánd a subsequent dispatch to the location of the patient. So this is an end-to-end system they're looking to create over the next couple of years. Click here to read more.

> Call for project ideas "Unwitnessed cardiac arrest" (EN)

Disclosure : I was part of the digital event kick-starting this, and will be connected assisting in the next steps.

Value creation and value distribution in the Dutch health ecosystem

Together with John Luijs and Mathieu van Bergen, I've written an article on The health(care) future of the Netherlands, we discussed five major shifts that will shape the Dutch health ecosystem of the future. These five shifts have the potential to create a great deal of value for Dutch citizens: we can gain years of healthy lives for lower costs. The shifts should be driven by innovations of parties that are currently already active in healthcare and of new players within the healthcare ecosystem. (click here for the Dutch version of that article) .

Together with John Luijs and Nicole Lentink in another article I went onto a 'journey of thoughts' to parallel the more 'regular' business models of innovation with how things work in healthcare.

In exchange for the resulting value that they create for Dutch citizens, there should also be value for them to distribute. Nevertheless, the reality appears to be different. One of the roadblocks preventing progress we run into almost everyday when trying to innovate is how to create value that in the end pays for the innovation at the same place costs are taken. For the existing healthcare ecosystem parties, value creation can be an elusive phenomenon. Initiatives that work well locally are not always upscaled sufficiently. However, initiatives that start on a larger scale become stranded in too much complexity. Besides the challenges relating to scale versus complexity, these parties also face conflicting stimuli in our system. In our system, the party with a key role in creating the added value can consequently lose out. 

For the new players in healthcare, our current healthcare ecosystem can seem a complicated labyrinth. A place with many stakeholders, established interests and inadequate market forces. These companies come from ecosystems with market forces where ‘value creation for an end-customer’ leads to a ‘return on investment’ in the form of a larger share in the ‘profit pool’. To them, healthcare often seems to be a place with a different language, where a different logic applies. Also, there is a difference between the US and the NL.

How can we unlock the potential value of the healthcare ecosystem of the future? 

The article starts by discussing the value potential of the five shifts and the challenges for realisation. Followed by a point of view from outside healthcare, in order to reveal the special dynamics of our current healthcare ecosystem. Based on our knowledge of and experience with other ecosystems, we offer an overview of typical ecosystem market forces dynamics in relation to value creation and value distribution. 

We use this to describe the current money flows in healthcare: who pays whom how much, and for what? After that we translate these insights into five fundamental system-level discussions that we feel must be taken into account in the debate on the future of Dutch health(care). We close this conceptual experiment with a concrete suggestion for a roadmap for value creation in the health ecosystem of the future.  Click to read more.

Working from home, stress, anxiety and loneliness have put our mental health under pressure. The current lockdown is putting this under even more pressure and with it the urgency to take action is growing.

Almost one in three Dutch people experience stress. Not just because of the pandemic; we have seen a worrying upward trend here for years. Employers are increasingly concerned about the mental health of their employees. Working from home completely, the uncertain economic future and less social connection have a major impact on the mental health of employees. At the same time, for a large group of people who do work on location, such as healthcare workers, the workload due to COVID-19 has increased enormously, both factually and psychologically. Many organizations see the need to gain a better understanding of and balance the mental health of their people. To help them, we want to broaden the focus around mental health from only curative (cure) to also preventive (prevention). Investing more in mental health will be able to slow down the ever-growing demand for care and the increasing costs thereof. Mental health should therefore become just as important as physical health.

At the moment I'm collaborating with Deloitte and the GGzE (one of the major innovative mental health institution in the Netherlands) exploring an interface of traditional players, such as the GGzE, together with employers like Nationale Nederlanden and Deloitte, how they can (get) or keep their employees mentally healthy (again). To explore together the challenges and solutions surrounding the mental health of employees and the role of the employer in this with early warming, early intervention preventing upscaling into mental healthCARE. More about this in one of the next newsletters.

And closing on a fun note; there is always a video about prevention on Youtube ...

Stay safe everyone!